Woman's heart revival an unexplained gift

Monday

Melissa Justice was on the operating table. In minutes, surgeons would open her chest to remove her heart. She'd been told she would die without the donor heart that awaited.

Melissa Justice was on the operating table. In minutes, surgeons would open her chest to remove her heart. She'd been told she would die without the donor heart that awaited.

First, though, the surgical team used ultrasound to look at her failing organ. A matter of procedure, really. Her heart was shot, and they knew it.

That was Jan. 11. Almost a year had passed since the 31-year-old woman came home from a cruise to celebrate her big promotion and, with little warning and no explanation, could no longer climb the stairs in her home.

In those intervening months, Justice had to leave her job and go on disability. Her husband, Ray, lost his travel companion and singing partner and became a caregiver. Her dad quit his job and moved from Cleveland to Grove City to help so Ray could keep working. A community of friends sustained a family that could scarcely believe what was transpiring.

Justice had a stroke. Her heart swelled to three times its normal size. She spent more time in the hospital than out.

Doctors, baffled as to why this had happened, implanted a device to help her heart along, to buy time. They told Justice that her best chance was a life with someone else's heart beating in her chest.

And so word spread quickly that January day after a donor heart became available. By the time Justice was wheeled into surgery, at least 40 people had gathered in a fourth-floor waiting area at Ohio State University's Richard M. Ross Heart Hospital. They talked, prayed, ate cold cuts and settled in to wait.

They hoped for a long wait, really. Successful transplants take time.

In the operating room, Dr. Benjamin Sun couldn't quite absorb it all. They had a donor heart for Justice. They were ready to go. But when they turned down the pump that was keeping her alive, the heart in her chest beat on its own with a strength they hadn't seen before.

"We're going, 'Holy moly, is this the same heart we looked at two weeks ago?'"

Sun, who directs cardiothoracic surgery, paced the operating room. He thought to himself, "If this were my wife, what would I do?"

He made sure they could send the donor heart elsewhere, to Pennsylvania where another sick patient waited.

He called Dr. Ayesha Hasan, Justice's heart-failure specialist and the medical director of the cardiac transplant program. It was the middle of the night. She was expecting the call, hoping for news of a successful surgery.

But when Sun explained the situation, "It was like something off of some TV show or something. It didn't seem real," Hasan said.

Justice's friends and family had been waiting only a couple of hours when the anesthesiologist left the operating room and headed to the waiting area. He explained that Sun needed to speak with her immediate family.

"We were so scared. We thought that she had died on the table," said Justice's mother, Susan Williams.

"And he said, 'I don't know how her heart got sick and I don't know how it got better, but I wouldn't take that heart out of her.'"

Justice's family rejoiced and prayed. "We knew it was an answered prayer," her mom said.

When Justice awoke, she made Ray tell her twice. Then she made her mother tell her twice. Then she made her sister confirm the news that didn't seem possible.

The phenomenon isn't unique. Sun saw a handful of such cases when he worked at New York's Columbia Presbyterian Medical Center.

But they're poorly understood. It's difficult even to figure out what causes heart failure in many patients, let alone decipher why the rare patient responds so well after months on a heart pump. Sun and others are working to try to better identify what makes this happen in hopes that they can use the information to heal others.

"In some ways, it makes sense," he said. "It's a muscle, and (with the pump) we're throwing it on a couch and we're asking it not to do any work."

In the seven months since the transplant that never happened, Justice and her husband have treasured their time. She still tires easier than she used to, and she doesn't feel as sharp mentally.

But she walks through her neighborhood almost every afternoon with a friend and can do everyday things such as cooking and cleaning. She and Ray recently ventured to Pittsburgh for a weekend.

Hasan and Sun have monitored her health closely. They've turned the pump as low as it can go and had her exercise on a treadmill to make sure her heart can withstand the exertion.

All along, and with the help of medications, they've seen improvement. She still has heart failure, but it's now become well-managed, not the death sentence it was just months ago.

"I believe that God healed me on that table, but I know that doctors think differently," Justice said.

On Sept. 9, Sun plans to remove the pump that has bolstered Justice's heart. The goal is to buy her years, even decades, of normal life. It's possible she'll find herself on the transplant list again, they say, but the longer she can survive with her own heart, the better.

"Her heart is beating very, very well right now; almost normal," Sun said.

Hasan has reveled in watching the transformation of a woman who once was one of her unhealthiest patients, she said, and commends Justice for "doing everything we've asked her to" in terms of exercise, medication and self care.

The couple has learned in the past year or so not to think too far ahead, and so Justice, who is 32, is approaching Sept. 9 with optimism and faith and without a lot of handwringing.

Even if she didn't make it another day, she said, these past seven months have been a gift, every minute she has spent enjoying time with Ray and her family.

mcrane@dispatch.com

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